Brief Answer:
Likely genetic but need exclusion of other causes
Detailed Answer:
Hi Mr. XXXXX,
Thanks for your query.
I have gone through your information and investigation reports thoroughly. Test reports provided by you are-by and large- within normal range, EXCEPT for the size Red Blood Cells which are near lower limits.
Firstly, your ideal weight for your age and height is 75kg or a body Mass Index(BMI) of 25.
Further,the causes of low body weight are :-
* Genetic : as in your case. Hence, you should not expect much increase in body weight.
* Chronic Illnesses :- Though you have mentioned that you have no problems, yet there are certain latent or undiagnosed chronic illnesses, such as Tuberculosis; Diabetes mellitus; mal-absorption or underlying latent liver diseases.
* Food intolerance/ allergies
* Inborn errors of
Hemoglobin (called hemoglobinopathies) such as Thallassemia
* Calorie + protein deficiency.
Hence, in order to PINPOINT the exact cause of gross
underweight (if any, apart from genetic predisposition); give you a SOUND professional advice; and, TRUE VALUE FOR YOUR MONEY, I request you to kindly provide additional information as follows :-
# Do you get episodes of diarrhea, abdominal discomfort, or intolerance to any particular food?
# Has there been an unexplained weight-loss in the recent past or your present body weight has been persistent?
# Get the following investigations done, to rule out underlying undiagnosed conditions:-
1. Fasting and Post-Prandial Blood Sugar to rule-out/confirm Diabetes
2. Liver Functions’ test (for evidence- if any- of chronic liver disease
3. Abdominal ultrasound for particularly pancreas, liver and kidneys for structural defect (if any) of these organs.
4. Peripheral Blood Picture (for abnormalities of Hemoglobin)
5. Blood Urea/
Creatinine and Routine and microscopic Urine examination for kidney problems
6. Blood
Vitamin B12 and Folate level estimation (in view of small-sized Red Blood Cells).
7. Chest X-Ray : to rule out/confirm occult/silent and undiagnosed tuberculosis
In the meanwhile- pending investigations:-
- take HIGH calorie (3000 Calories), HIGH Protein diet.
- Vitamin B12 (
methylcobalamin) 1500mcg/day;
Folic Acid 5mg/day; Probiotics, such as lactobacilli and digestive enzymes.
- A deworming course (
Albendazole 400mg - single tablet and repeat it every month.
- Maintain WEEKLY record of body weight.
I SHALL BE WAITING TO HEAR BACK FROM YOU ALONG WITH ADDITIONAL INFORMATION (as advised) and ALL TESTS’ REPORTS.
Lastly, low body weight should ALWAYS be investigated, despite a strong suspicion of it being due to genetic predisposition. SO, PLEASE DO NOT TAKE IT LIGHTLY.
I WILL GUIDE YOU FURTHER COURSE OF ACTION, ONCE THE TEST REPORTS ARE RECEIVED.
Fond regards and have a nice day
Dr. Rakesh Karanwal
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports.
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